Healthcare Provider Details

I. General information

NPI: 1992700439
Provider Name (Legal Business Name): INFUSACARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

864 WILSON DR STE A
RIDGELAND MS
39157-4512
US

IV. Provider business mailing address

PO BOX 2720
RIDGELAND MS
39158-2720
US

V. Phone/Fax

Practice location:
  • Phone: 601-956-5272
  • Fax: 601-956-2474
Mailing address:
  • Phone: 601-956-5272
  • Fax: 601-956-2474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number02417 / 02.1
License Number StateMS

VIII. Authorized Official

Name: MR. B. LEE ATKINS
Title or Position: PRESIDENT
Credential: R PH.
Phone: 601-956-5272